Journal of Clinical Monitoring and Computing - J CLIN MONITOR COMPUT, 2000
Objective.To describe a new pulse oximetry technology and measurement paradigm developed by Masim... more Objective.To describe a new pulse oximetry technology and measurement paradigm developed by Masimo Corporation.Introduction.Patient motion, poor tissue perfusion, excessive ambient light, and electrosurgical unit interference reduce conventional pulse oximeter (CPO) measurement integrity. Patient motion frequently generates erroneous pulse oximetry values for saturation and pulse rate. Motion-induced measurement error is due in part to wide spread implementation of a theoretical pulse oximetry model which assumes that arterial blood is the only light-absorbing pulsatile component in the optical path. Methods.Masimo Signal Extraction Technology(SET®) pulse oximetry begins with conventional red and infrared photoplethysmographic signals, and then employs a constellation of advanced techniques including radiofrequency and light-shielded optical sensors, digital signal processing, and adaptive filtration, to measure SpO2 accurately during challenging clinical conditions. In contrast to ...
Images of the Twenty-First Century. Proceedings of the Annual International Engineering in Medicine and Biology Society
The results of study of a three-component (pH, PaCO2, PaO2) intra-arterial optode in patients und... more The results of study of a three-component (pH, PaCO2, PaO2) intra-arterial optode in patients undergoing surgical procedures are presented. Twenty-five surgical patients who required radial artery cannulation took part in this study. In each patient, the fiber-optic sensor (0.63 mm in diameter) was inserted into the arterial cannula. Results for the different cannula sizes are analyzed separately. A scatter plot
Journal of Clinical Monitoring and Computing, Oct 1, 1986
Both halothane and nitrous oxide can be reduced at the cathode of a polarographic oxygen electrod... more Both halothane and nitrous oxide can be reduced at the cathode of a polarographic oxygen electrode, causing the electrode current to drift upward and report falsely high oxygen tension. Because transcutaneous oxygen tension is measured by a heated oxygen electrode, there is a potential for significant upward drift of these values. To examine the clinical significance of this drift, the following study was performed. Transcutaneous oxygen tension sensors were calibrated at oxygen tensions of 0 mm Hg and 157 mm Hg (room air) just before clinical use during anesthesia. This calibration was rechecked immediately upon removal of the sensor from the patient at the end of the anesthesia. The predominant anesthetic agent used and the duration of monitoring were noted from the record. Data were collected from 208 patients representing a total of 463.6 hours of anesthesia. The patients were divided into five groups based on anesthetic administered: halothane, enflurane, isoflurane, nitrous oxide-narcotic, and local/regional. The mean zero point recalibration value was 0.4 mm Hg or less for all agents except halothane, for which it was 1.8 +/- 3.2 mm Hg. This halothane drift was significantly greater than that for the other agents (P less than 0.01). Room air recalibration was not significantly different in any of the five groups, varying from 160 +/- 4.9 mm Hg for halothane to 157 +/- 4.9 mm Hg for enflurane. All these drift values are within the manufacturer's specifications. We conclude that the drift of the transcutaneous oxygen tension sensor due to anesthetic agents is not clinically significant. However, caution should be exercised when halothane is used during an extremely long period of anesthesia.
Previous studies have shown that pulse oximeters whose sensors are positioned improperly may yiel... more Previous studies have shown that pulse oximeters whose sensors are positioned improperly may yield erroneously low saturation (SpO2) values on normoxemic subjects. The behavior of oximeters with malpositioned sensors during hypoxemia has not been studied. The current study is aimed at determining the behavior of several different pulse oximeters over a wide range of arterial oxygen saturation (SaO2). In each of 12 healthy volunteers, a radial artery cannula was inserted, and eight different pulse oximeters, five of which had malpositioned sensors, were applied. Subjects breathed controlled mixtures of nitrogen and oxygen to slowly vary their SaO2 from 100% to 70%. Arterial blood samples were analyzed and pulse oximeter data were recorded at five stable SaO2 values for each subject. The oximeters with malpositioned sensors vary greatly in their behavior, depending on both the actual SaO2 and the manufacturer and model. One oximeter underestimated saturation at all SaO2 values, while three others underestimated at high SaO2 and overestimated at low SaO2. Linear regression analysis shows a decrease in the slope of SpO2 versus SaO2 in most cases, indicating a loss of sensitivity to SaO2 changes. Between-subject variation in response curves was significant. The calibration curves of the pulse oximeters studied were changed greatly by sensor malpositioning. At low SaO2 values, these changes could cause the oximeter to indicate that a patient was only mildly hypoxemic when, in fact, hypoxemia was profound. It is recommended that sensor position be checked frequently and that inaccessible sensor locations be avoided whenever possible.
Journal of Clinical Monitoring and Computing - J CLIN MONITOR COMPUT, 2000
Objective.To describe a new pulse oximetry technology and measurement paradigm developed by Masim... more Objective.To describe a new pulse oximetry technology and measurement paradigm developed by Masimo Corporation.Introduction.Patient motion, poor tissue perfusion, excessive ambient light, and electrosurgical unit interference reduce conventional pulse oximeter (CPO) measurement integrity. Patient motion frequently generates erroneous pulse oximetry values for saturation and pulse rate. Motion-induced measurement error is due in part to wide spread implementation of a theoretical pulse oximetry model which assumes that arterial blood is the only light-absorbing pulsatile component in the optical path. Methods.Masimo Signal Extraction Technology(SET®) pulse oximetry begins with conventional red and infrared photoplethysmographic signals, and then employs a constellation of advanced techniques including radiofrequency and light-shielded optical sensors, digital signal processing, and adaptive filtration, to measure SpO2 accurately during challenging clinical conditions. In contrast to ...
Images of the Twenty-First Century. Proceedings of the Annual International Engineering in Medicine and Biology Society
The results of study of a three-component (pH, PaCO2, PaO2) intra-arterial optode in patients und... more The results of study of a three-component (pH, PaCO2, PaO2) intra-arterial optode in patients undergoing surgical procedures are presented. Twenty-five surgical patients who required radial artery cannulation took part in this study. In each patient, the fiber-optic sensor (0.63 mm in diameter) was inserted into the arterial cannula. Results for the different cannula sizes are analyzed separately. A scatter plot
Journal of Clinical Monitoring and Computing, Oct 1, 1986
Both halothane and nitrous oxide can be reduced at the cathode of a polarographic oxygen electrod... more Both halothane and nitrous oxide can be reduced at the cathode of a polarographic oxygen electrode, causing the electrode current to drift upward and report falsely high oxygen tension. Because transcutaneous oxygen tension is measured by a heated oxygen electrode, there is a potential for significant upward drift of these values. To examine the clinical significance of this drift, the following study was performed. Transcutaneous oxygen tension sensors were calibrated at oxygen tensions of 0 mm Hg and 157 mm Hg (room air) just before clinical use during anesthesia. This calibration was rechecked immediately upon removal of the sensor from the patient at the end of the anesthesia. The predominant anesthetic agent used and the duration of monitoring were noted from the record. Data were collected from 208 patients representing a total of 463.6 hours of anesthesia. The patients were divided into five groups based on anesthetic administered: halothane, enflurane, isoflurane, nitrous oxide-narcotic, and local/regional. The mean zero point recalibration value was 0.4 mm Hg or less for all agents except halothane, for which it was 1.8 +/- 3.2 mm Hg. This halothane drift was significantly greater than that for the other agents (P less than 0.01). Room air recalibration was not significantly different in any of the five groups, varying from 160 +/- 4.9 mm Hg for halothane to 157 +/- 4.9 mm Hg for enflurane. All these drift values are within the manufacturer's specifications. We conclude that the drift of the transcutaneous oxygen tension sensor due to anesthetic agents is not clinically significant. However, caution should be exercised when halothane is used during an extremely long period of anesthesia.
Previous studies have shown that pulse oximeters whose sensors are positioned improperly may yiel... more Previous studies have shown that pulse oximeters whose sensors are positioned improperly may yield erroneously low saturation (SpO2) values on normoxemic subjects. The behavior of oximeters with malpositioned sensors during hypoxemia has not been studied. The current study is aimed at determining the behavior of several different pulse oximeters over a wide range of arterial oxygen saturation (SaO2). In each of 12 healthy volunteers, a radial artery cannula was inserted, and eight different pulse oximeters, five of which had malpositioned sensors, were applied. Subjects breathed controlled mixtures of nitrogen and oxygen to slowly vary their SaO2 from 100% to 70%. Arterial blood samples were analyzed and pulse oximeter data were recorded at five stable SaO2 values for each subject. The oximeters with malpositioned sensors vary greatly in their behavior, depending on both the actual SaO2 and the manufacturer and model. One oximeter underestimated saturation at all SaO2 values, while three others underestimated at high SaO2 and overestimated at low SaO2. Linear regression analysis shows a decrease in the slope of SpO2 versus SaO2 in most cases, indicating a loss of sensitivity to SaO2 changes. Between-subject variation in response curves was significant. The calibration curves of the pulse oximeters studied were changed greatly by sensor malpositioning. At low SaO2 values, these changes could cause the oximeter to indicate that a patient was only mildly hypoxemic when, in fact, hypoxemia was profound. It is recommended that sensor position be checked frequently and that inaccessible sensor locations be avoided whenever possible.
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